What is pelvic organ prolapse?
prolapse occurs when a pelvic organ, such as your bladder, drops (prolapses)
from its normal spot in your lower belly and pushes against the sides of your
vagina. This can happen when the muscles that hold your pelvic organs in place
get weak or stretched from childbirth or surgery.
The most common
organ prolapse involves the
More than one pelvic organ can
prolapse at the same time. Other organs that can be involved when you have
pelvic prolapse include your:
- Urethra .
- Uterus .
- Small bowel .
- Rectum .
Symptoms of pelvic organ prolapse can depend on the
organs involved. But the most common symptoms include:
- Feeling pressure from pelvic organs pressing against the sides
of your vagina.
- Feeling very full in your lower belly.
- Feeling as if something is falling out of your vagina or
feeling something in your vagina when you wipe after using the bathroom.
- Feeling a pull or stretch in your groin area or pain in your
- Releasing urine without meaning to (incontinence), or needing
to urinate a lot.
- Having pain during sex.
- Having problems with your bladder or bowels, such as
constipation or problems emptying your bladder.
Many women with pelvic organ prolapse have only mild
symptoms. Surgery is usually only done when the prolapse is affecting your
daily life and your doctor thinks surgery will help. Consider surgery
- The prolapse causes pain.
- You have problems with your bladder and bowels.
- The prolapse makes it hard for you to do activities you
What kinds of surgery are done for pelvic organ prolapse?
Many kinds of surgery can be done for pelvic organ
prolapse. The type of surgery you have will depend on which organs are
Types of surgery include:
- Repair of the vaginal wall (vaginal vault prolapse surgery).
- Repair of the bladder (cystocele surgery) or urethra (urethrocele surgery).
- Repair of the rectum (rectocele surgery) or small bowel (enterocele surgery).
- Surgery to close the vagina (vaginal obliteration). This surgery is only an option if you no longer want to
- Removal of the uterus (hysterectomy).
During surgery for bladder, urethra, rectum, and small
bowel prolapse, the surgeon makes a cut, called an incision, in the wall of the
vagina. He or she pulls together the loose or torn tissue in the area of the
prolapsed organ and strengthens the wall of the vagina to keep the prolapse
from coming back.
During surgery for vaginal vault prolapse, the
surgeon makes an incision in the wall of the vagina. He or she attaches the top
of the vagina to the wall of the lower belly, to the spine in the lower back,
or to the
ligaments of the pelvis.
hysterectomy, the surgeon removes the uterus. During a vaginal obliteration,
the surgeon removes most of the vaginal lining and then sews the vagina shut.
If the uterus is still present, a small opening is left to allow fluid to drain
from the uterus.
These surgeries are usually performed by a
gynecologist or a urologist. You will have medicine to make you sleepy during
the surgery (anesthesia). You may stay in the hospital for a day or
two. You may go home with a catheter, a flexible plastic tube that drains urine
from your bladder when you can't urinate by yourself.
surgery, you will likely be able to return to your normal activities in about 6
For the first 3 months after surgery, you will need to
take it easy and avoid heavy lifting or long periods of standing. Your prolapse
can return if you strain or lift too soon after surgery.
be best to delay surgery if you plan to have children. The strain of childbirth
could cause your problem to come back.
What are the risks of surgery for pelvic organ prolapse?
Problems you may have after surgery can include:
- Not being able to empty your bladder.
- Pain during sex.
- Bladder injury.
- A hole or opening that forms between two organs in your body,
or between your body and your skin. This is called a
Surgery for pelvic organ prolapse is done to treat
symptoms caused by one prolapsed organ, so you may still have other symptoms
after your surgery. Surgery in one part of your pelvis can make a prolapse in
another part worse. This may mean that you have to have another surgery
Pelvic organ prolapse can come back after surgery. How well
surgery works depends on the type of surgery. But on average, about 3 out of 10
women who have the surgery end up having a second surgery within 4
chances for success can be higher when a woman has two surgical procedures
during the same operation-one to correct the prolapse and the other to help
prevent incontinence problems that can arise after surgery. But more research
is needed to find out if this is true for all types of prolapse
What are my other choices besides surgery?
may be able to relieve some symptoms of pelvic organ prolapse on your own. Try
special exercises, called
Kegels, that make your pelvic muscles stronger. Cut
back on caffeine, which acts as a
diuretic and can make you urinate more often. Eat
foods that are high in fiber to avoid constipation and straining when you have
a bowel movement. Reach and stay at a healthy weight. More weight puts pressure
on your pelvic muscles. And avoid lifting heavy things that put stress on your
If you choose, your doctor can have you fitted
with a device called a
pessary . A pessary can help you cope with pelvic organ
prolapse. It's a removable device that you put in your vagina. It holds the
pelvic organs in place. Pessaries can be useful if you do not want surgery or
can't have surgery. Many women can control their symptoms for years by using a
If you need more information, see the topic
Pelvic Organ Prolapse.